Urbanization and psychosis: a study of 1942-1978 birth cohorts in The Netherlands
Urbanization and psychosis: a study of 1942-1978 birth cohorts in The Netherlands
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DOI：
10.1017/s0033291798006898
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发表时间：
1998-07-01
影响因子：
6.9
通讯作者：
van Os, J
中科院分区：
文献类型：
--
作者：
Marcelis, M;Navarro-Mateu, F;van Os, J
背景城市出生与晚期精神分裂症有关。本研究探讨了这一发现是否是诊断特异性的，哪些人是最危险的。所有活产记录在1942年和1978年之间的任何646个荷兰城市进行了后续的通过国家精神病病例登记为第一精神病入院精神病1970年和1992年之间（N = 42115）。城市出生与晚期精神分裂症（发病率比线性趋势（IRR），1.39; 95%置信区间（95%CI），1.36-1.42）、情感性精神病（IRR，1.18; 95%CI，1.15-1.21）和其他精神病（IRR，1.27; 95%CI，1.24-1.30）呈线性相关。出生在三个城市暴露水平中最高类别的个人患精神分裂症的可能性约为两倍。男性和发病年龄较早的个体之间的相关性更强。城市出生的影响在最近的出生群体中也更强。在城市出生和后来的精神障碍之间的关联强度的诊断类别之间存在定量差异。城市地区精神病发病率高可能是与城市化有关的环境因素造成的，其影响似乎在连续几代人中不断增加。
Background. Urban birth is associated with later schizophrenia. This study examined whether this finding is diagnosis-specific and which individuals are most at risk.Methods. All live births recorded between 1942 and 1978 in any of the 646 Dutch municipalities were followed-up through the National Psychiatric Case Register for first psychiatric admission for psychosis between 1970 and 1992 (N = 42115).Results. Urban birth was linearly associated with later schizophrenia (incidence rate ratio linear trend (IRR), 1.39; 95 % confidence interval (95 % CI), 1.36-1.42), affective psychosis (IRR, 1.18; 95 % CI, 1.15-1.21) and other psychosis (IRR, 1.27; 95 % CI, 1.24-1.30). Individuals born in the highest category of the three-level urban exposure were around twice as likely to develop schizophrenia. Associations were stronger for men and for individuals with early age of onset. The effect of urban birth was also stronger in the more recent birth cohorts.Conclusions. There are quantitative differences between diagnostic categories in the strength of the association between urban birth and later psychiatric disorder. High rates of psychosis in urban areas may be the result of environmental factors associated with urbanization, the effect of which appears to be increasing over successive generations.